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  The diagnostic tests include several imaging studies like plain radiograph which shows the curved appearance of the residual sacrum, scalloped beneath the defect, this finding is considered as almost pathognomonic, and is present in 50% of cases.\cite{3335662} Abdominal ultrasound could reveal the presence of the intra-abdominal cystic abnormality, careful examination should be made to avoid misdiagnosis with cysts in other locations, a typical example of this is the confusion with ovarian cysts, as happened with our patient, and has been described in other reports.\cite{16673368}\cite{23486628} ... CT-scans are useful to display bony anomalies and lumbar erosions[6]. Intrathecal contrast enhanced CT scanning is the diagnostic procedure of choice, since demonstrates the communication between the meningocele and the subarachnoid spaces [13]. However, this method usually is descarted as is invasive and has the disadvantage of ionizing radiation. MRI is a safe, rapid, and noninvasive imaging method with the advantage that it can also show any associated tumors.[13   - approaches  Surgical options consist primarily of either a posterior transsacral or an anterior transabdominal approaches. Several reports have stressed the advantages of the posterior transsacral technique, which offers (citas), anterior transabdominal approach \cite{16793455}